Disability Doc

6.01 Category of Impairments, Genitourinary System

*Effective September 6, 2005*

6.02 Impairment of renal function, due to any chronic renal disease that has lasted or can be expected to last for a continuous period of at least 12 months. With:
A. Chronic hemodialysis or peritoneal dialysis (see 6.00E1).
or
B. Kidney transplantation. Consider under a disability for 12 months following surgery; thereafter, evaluate the residual impairment (see 6.00E2).
or
C. Persistent elevation of serum creatinine to 4 mg per deciliter
(dL) (100 ml) or greater or reduction of creatinine clearance to 20 ml per minute or less, over at least 3 months, with one of the following:
1. Renal osteodystrophy (see 6.00E3) manifested by severe bone pain and appropriate medically acceptable imaging demonstrating abnormalities such as osteitis fibrosa, significant osteoporosis, osteomalacia, or pathologic fractures;
or
2. Persistent motor or sensory neuropathy (see 6.00E4);
or
3. Persistent fluid overload syndrome with:
a. Diastolic hypertension greater than or equal to diastolic blood pressure of 110 mm Hg;
or
b. Persistent signs of vascular congestion despite prescribed therapy (see 6.00B5);
or
4. Persistent anorexia with recent weight loss and current weight meeting the values in 5.08, table III or IV.

6.06 Nephrotic syndrome, with anasarca, persisting for at least 3 months despite prescribed therapy (see 6.00E5). With:
A. Serum albumin of 3.0 g per dL (100 ml) or less and proteinuria of 3.5 g or greater per 24 hours.
or
B. Proteinuria of 10.0 g or greater per 24 hours.

On September 6, 2005, the new genitourinary system listings became effective.

In turn, the following genitourinary system listings were removed:

Prior listing 6.02C2 - clinical episode of pericarditis

Prior listing 6.02C4 - intractable pruritus

SSA notes that these two listings were removed because current treatment for most individuals with chronic renal disease includes the initiation of dialysis earlier in the course of treatment. SSA further makes the assumption that if you have pericarditis or intractable pruritus, you usually will be receiving dialysis; in that case, your impairment will meet final listing 6.02A.

Prior listing 6.02C7 - persistent hematocrits of 30 percent or less

SSA notes this is because hematocrits at this level do not necessarily correlate with an inability to do any gainful activity. SSA goes on to say that they may still find you disabled if you have chronic renal disease and persistently low hematocrit levels. They will consider the facts of your individual case, including your symptoms, such as fatigue and weakness, which may limit your ability to function and work.